NSCLC患者化疗前后血清CA125、CYFRA21⁃1、MMP⁃9水平变化及临床意义  

Changes in serum CA125,CYFRA21⁃1 and MMP⁃9 levels before and after chemotherapy in NSCLC patients and their clinical significance

作　　者：韩卫 张东远[1] HAN Wei;ZHANG Dongyuan(Department of Oncology,the First People's Hospital of Mengcheng,Bozhou,Anhui 233500,China)

机构地区：[1]蒙城县第一人民医院肿瘤内科,安徽亳州233500

出　　处：《热带医学杂志》2024年第7期1008-1011,1025,F0003,共6页Journal of Tropical Medicine

基　　金：安徽省中央引导地方科技发展专项(201707d08050003)。

摘　　要：目的检测非小细胞肺癌(NSCLC)患者化疗前后血清癌抗原125(CA125)、细胞角蛋白19片段抗原21⁃1(CYFRA21⁃1)、基质金属蛋白酶-9(MMP⁃9)水平,分析其与化疗后肺部感染的相关性。方法选取2019年11月-2024年3月于蒙城县第一人民医院肿瘤科就诊的NSCLC患者80例作为研究对象,所有患者入院后均接受常规检查,排除相关禁忌证后,予以顺铂+紫杉醇化疗方案,化疗4个周期后根据临床疗效分为完全缓解(CR)组(n=0)、部分缓解(PR)组(n=27)、疾病稳定(SD)组(n=34)、疾病进展(PD)组(n=19)。根据肺部感染情况分为感染组(n=23)和非感染组(n=57)。所有患者化疗前后收集外周血,测量血清CA125、CYFRA21⁃1、MMP⁃9表达水平,采用受试者工作特征(ROC)曲线分析CA125、CYFRA21⁃1、MMP⁃9对NSCLC化疗后肺部感染的预测价值。结果化疗后患者血清CA125、CYFRA21⁃1、MMP⁃9水平均显著低于化疗前,差异均有统计学意义(t=6.993、9.458、6.818,P均<0.001)。PR组、SD组患者化疗后CA125、CYFRA21⁃1、MMP⁃9均较化疗前显著降低,差异均有统计学意义(tPR组=3.010、17.524、3.219,P均<0.05;tSD组=9.689、10.879、6.411,P均<0.05);PD组患者化疗后CYFRA21⁃1较化疗前显著降低,差异有统计学意义(t=12.990,P<0.001)。80例NSCLC患者中,感染组患者血清CA125、CYFRA21⁃1、MMP⁃9水平显著高于非感染组,差异均有统计学意义(t=4.106、6.543、5.128,P均<0.001)。ROC曲线提示,CA125、CYFRA21⁃1、MMP⁃9预测NSCLC患者化疗后肺部感染的灵敏度分别为72.5%、77.6%、69.7%,特异度分别为79.9%、76.3%、73.9%,曲线下面积(AUC)分别为0.843、0.846、0.864,3项指标联合检测灵敏度为81.6%,特异度为72.2%,AUC为0.920。结论CA125、CYFRA21⁃1、MMP⁃9水平与NSCLC患者化疗疗效及化疗后肺部感染有显著的关联,且对化疗后肺部感染具有较高的预测价值。Objective To assess the association between serum concentrations of cancer antigen125(CA125),cytokeratin 19 fragment antigen 21⁃1(CYFRA21⁃1),matrix metallo⁃proteinase⁃9(MMP⁃9),and the effectiveness of chemotherapy and pulmonary infection in patients with non⁃small cell lung cancer(NSCLC)both before and during treatment.Methods A total of 80 patients with NSCLC who were treated in the Oncology Department of Mengcheng county the First People's Hospital from November 2019 to March 2024 were selected as the study subjects.All patients received routine examination after admission and were given cisplatin+paclitaxel chemotherapy regimen after relevant conjunctions were excluded.After 4 cycles of chemotherapy,they were divided into complete response(CR)group(n=0),partial response(PR)group(n=27),stable disease(SD)group(n=34),and disease progression(PD)group(n=19)according to clinical efficacy.The expression levels of serum CA125,CYFRA21⁃1 and MMP⁃9 were measured in peripheral blood of all patients before and after chemotherapy.Peripheral blood of all patients was collected before and after chemotherapy.The predictive value of CA125,CYFRA21⁃1,and MMP⁃9 for pulmonary infection following chemotherapy in NSCLC was determined using a receiver operating characteristic(ROC)curve.Results After chemotherapy,serum CA125,CYFRA21⁃1 and MMP⁃9 levels were significantly lower than those before chemotherapy,the differences were statistically significant(t=6.993,9.458,6.818;all P<0.001).CA125,CYFRA21⁃1 and MMP⁃9 after chemotherapy in partial response(PR)and stable disease(SD)groups were significantly decreased compared with those before chemotherapy(tPR group=3.010,17.52,3.219,all P<0.05;tSD group=9.689,10.879,6.411,all P<0.001).In progressive disease(PD)group,CYFRA21⁃1 after chemotherapy was significantly lower than that before chemotherapy(t=12.990,P<0.001).Among all the 80 patients,the serum levels of CA125,CYFRA21⁃1 and MMP⁃9 in the infected group were significantly higher than those in the non⁃inf

关 键 词：非小细胞肺癌 癌抗原 细胞角蛋白19片段抗原21⁃1 基质金属蛋白酶-9 

分 类 号：R734.2[医药卫生—肿瘤]